How to teach a child to use a PECS sentence strip

A PECS sentence strip helps a child move from exchanging one picture to creating a short, meaningful message. Instead of handing over a single symbol for “cracker” or “ball,” the child learns to combine a sentence starter such as “I want” with a picture representing the desired item.

The Picture Exchange Communication System (PECS) is a structured augmentative and alternative communication approach. It is often used with autistic children and other learners who have limited spoken language, but the teaching principles can support any child who benefits from visual communication. The goal is functional communication, not memorizing a routine without understanding.

A successful program should be individualized by a speech-language pathologist and coordinated with caregivers, teachers, and other members of the child’s team. Rachel Jones shares practical speech therapy resources that can help professionals and families plan consistent language-learning opportunities.

Check readiness before teaching sentence building

A child usually benefits from learning the earlier PECS skills before working on a sentence strip. They should understand that handing a picture to a communication partner produces a meaningful result. They also need enough motor control to pick up a symbol, travel to a partner, and release it into the partner’s hand.

The child does not need to speak, point, or identify pictures by name before beginning. However, they should show a reason to communicate and be able to make a purposeful picture exchange with support. If the child is still dropping pictures, grabbing an entire communication book, or waiting for adults to guess what they want, return briefly to the foundational exchange skills.

Choose highly motivating items and activities. Observe what the child reaches toward, searches for, tries to obtain, or enjoys repeatedly. A favorite snack, sensory activity, toy, song, or movement game may create a stronger reason to communicate than an item selected by an adult.

Prepare the symbols and communication book

Begin with a sentence strip attached to the front of the child’s communication book or placed on a stable surface. Use a removable “I want” symbol and a clear picture of the requested item. The symbols should be large enough for the child to discriminate and manipulate easily, with simple images and consistent placement.

Keep the sentence starter in a predictable location. The item symbols can be stored inside the book or on a nearby communication page. At first, present one highly preferred item picture. This reduces visual clutter and lets the child focus on the motor sequence: remove the item picture, place it beside “I want,” remove the completed strip, and exchange it with the communication partner.

The communication partner should sit or stand close enough to respond quickly. Keep the preferred item visible but under adult control. Avoid placing it so far away that the child loses interest, and avoid giving it immediately without an exchange when the teaching opportunity is intentional.

Teach the sentence strip step by step

Model the complete message while allowing the child to do as much of the sequence as possible. For example, when the child reaches for bubbles, help them locate the “bubbles” picture, place it beside “I want,” pick up the strip, and give it to the partner. Then read the message naturally: “I want bubbles,” and provide the bubbles promptly.

Use graduated physical prompting rather than repeated verbal directions. A prompt might begin with gentle assistance at the elbow or wrist and gradually become lighter as the child learns the routine. Try not to rely on verbal cues such as “Use your words” or “Tell me what you want,” because these can create dependence on spoken reminders.

Reinforcement should be immediate and meaningful. Once the child exchanges the completed strip, acknowledge the message, read it aloud, and deliver the requested item or activity. The communication partner should avoid making the child wait while asking extra questions. The exchange itself is the response that earns reinforcement.

Practice in short, frequent sessions across the day. Several successful exchanges during snack, play, art, or outdoor activities are usually more useful than one long drill. Once the child can complete the routine with one preferred item, vary the activity and communication partner so the skill becomes functional rather than tied to one set of materials.

Build independence and flexibility

When the child consistently completes the sentence strip with physical assistance, begin fading prompts. Reduce the amount of physical help, pause briefly before assisting, and position yourself so the child has an opportunity to initiate the next step. Fade prompts systematically rather than removing them suddenly and allowing repeated errors.

Teach the child to travel to the communication partner with the completed strip. This is an important part of functional communication. A child who constructs a sentence but leaves it on the table has not yet learned how to use the message to influence another person.

Gradually add more item pictures and teach discrimination. Start with two pictures that look different and represent different outcomes, such as “juice” and “car.” Offer the child access to the item selected, even when the choice is unexpected, so the picture remains meaningful. If the child chooses incorrectly, use a calm correction routine instead of turning the activity into a test.

The longer-term aim is flexibility. The child may eventually use “I want” with foods, toys, people, locations, and activities. Later teaching may include commenting, answering simple questions, describing actions, or using other sentence starters. Continue honoring spontaneous communication while expanding the child’s options.

Match prompts, materials, and partner responses

Teaching element	Helpful practice	Common problem
Sentence starter	Keep “I want” in a consistent position	Moving it frequently makes the routine harder to learn
Item picture	Use a clear symbol for a highly preferred item	Presenting too many low-interest symbols reduces motivation
Physical prompting	Assist only as much as needed and fade gradually	Pulling the child through every step can create prompt dependence
Partner response	Read the message and deliver the requested item quickly	Delaying reinforcement weakens the connection between exchange and outcome
Communication distance	Encourage travel to the partner and strip	Accepting messages left across the room limits functional use
Error correction	Re-teach the relevant step calmly	Repeated verbal “no” responses may discourage communication
Generalization	Practice with different people, places, and activities	Using the strip only during therapy limits carryover

Consistency matters more than having identical materials in every setting. A classroom might use a wall-mounted communication book, while a family uses a portable book or speech-generating device. The key features should remain understandable: recognizable symbols, a reliable sentence structure, and a partner who responds to communication.

Share the prompting plan with everyone who works with the child. If one adult waits for the child to build and exchange a sentence while another immediately guesses and gives the item, the child receives mixed information. A brief written plan can explain which prompt to use, how long to pause, how to reinforce, and how to record progress.

Troubleshoot common communication barriers

Some children remove the item picture but do not attach it to the sentence starter. In that case, focus on the next small step and use a light physical prompt to guide the placement. Keep the exchange successful, then gradually reduce assistance. The child may understand the pictures but need more practice with the motor planning sequence.

If a child repeatedly selects the wrong picture, examine the symbols first. The images may be too similar, too small, or unfamiliar. Confirm that the child has experienced the item represented by the picture. Present fewer choices, improve the contrast between symbols, and teach the meaning through real activities rather than picture drills alone.

If the child becomes upset, stop and identify the source. The task may be too difficult, the preferred item may be unavailable, the partner may be prompting too quickly, or the child may be communicating something other than a request. Offer an easier exchange, honor any clear communication, and adjust the teaching environment.

Some children learn to build “I want” only when an adult holds the desired item in view. Once the routine is established, create natural opportunities in which the item is visible, partially visible, or associated with an activity. Do not remove motivation altogether; instead, help the child use the sentence strip across increasingly ordinary situations.

Support carryover at home and school

Use the sentence strip during real routines such as breakfast, getting dressed, play, reading, and community outings. Adults can arrange the environment to create useful communication opportunities without withholding necessities. For example, place several preferred art materials in view while keeping them accessible through the communication system.

Accept every appropriate attempt to communicate. If the child exchanges a single item picture when a sentence is expected, provide the item and then model the sentence strip for the next opportunity. Communication should remain effective and respectful while the child is learning a more advanced form.

Record simple observations: what the child requested, how much prompting was needed, whether the child traveled to the partner, and whether the skill occurred with different people. These notes help the SLP decide when to add symbols, change prompts, or move toward commenting and more complex language.

• Keep preferred items available for communication practice throughout the day.
• Use the same sentence-starter location across home, school, and therapy when possible.
• Pause long enough for the child to initiate before offering physical assistance.
• Respond to the completed exchange immediately and read the message naturally.
• Celebrate independent communication instead of requiring extra performances after the request.

A PECS sentence strip is most powerful when it gives a child a dependable way to express wants, make choices, and participate with other people. Teach the routine in small steps, preserve the meaning of each exchange, and build practice into activities the child already enjoys. With coordinated support and thoughtful prompt fading, the strip can become a bridge from isolated picture requests to more flexible functional language.

Explore practical materials and ideas from Let’s Talk Speech Therapy, and use the approach that fits the child’s communication profile, interests, and daily environments. Start with one meaningful request, create a successful exchange, and build from there.